Individual provider Active NPI

Angela M Park, MD

  • Clinical Cardiac Electrophysiology Physician
  • New Bern, NC
National Provider Identifier
1720042013
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
200600085 Issued in NC
Practice address
1001 Newman Rd
New Bern, NC 28562-5253
Phone
(252) 635-6777
Fax
(252) 634-3183
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 200600085 NC Primary

Addresses

Primary practice location

1001 Newman Rd
New Bern, NC 28562-5253

Mailing address

PO Box 896206
Charlotte, NC 28289-6206
Phone (252) 635-6777

Other identifiers 2

IdentifierTypeStateIssuer
5903061MedicaidNC
142C6OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060804000127 NC Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 7719968601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinaeast PhysiciansGroup PAC ID 0143378117, 203 clinicians

Practice addresses (Care Compare)

4252 Arendell St
Suite E
Morehead City, NC 28557-0015
Phone (252) 635-6777

Hospital & facility affiliations

  • Carolina East Medical Center Hospital, New Bern, NC, CCN 340131
  • Duke University Hospital Hospital, Durham, NC, CCN 340030

Merit-based Incentive Payment System (MIPS)

Final score
72.61 of 100Reported as group
Quality
57.39
Promoting interoperability
68
Improvement activities
40
Cost
77.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200600085NCMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians CurrentSince Apr 1, 2009 Accepting new patients
Carolinaeast Physicians CurrentSince Apr 1, 2009 Accepting new patients
The Heart Center of Eastern Carolina Past Accepting new patients
Carolinaeast Physicians Past Accepting new patients
Carolinaeast Physicians Past Accepting new patients

Locations

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

4252 Arendell St
Ste E
Morehead City, NC 28557
Phone (252) 808-0145

1010 Medical Park Ave
New Bern, NC 28562
Phone (252) 636-5135

1001 Newman Rd
New Bern, NC 28562
Phone (252) 635-6777

705 Newman Rd
New Bern, NC 28562
Phone (252) 633-2712

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

Interoperability endpoints

  • Direct secure messaging: apark21899@carolinaeastmc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1720042013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896206",
            "telephone_number": "252-635-6777",
            "fax_number": "252-634-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625253",
            "telephone_number": "252-635-6777",
            "fax_number": "252-634-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "200600085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903061",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "142C6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.